Tendencia en el estudiante de medicina a ejercer como médico general o especialista / Trends among medical students towards general practice or specialization

ABSTRACT

Background: A 60/40 ratio has been estimated as a country's ideal proportion between general practitioners and specialists. In Chile this proportion was 36/ 64 in 2004, exactly the opposite of the ideal. Trends towards specialization or general practice among medical students have not been thoughtfully studied. Aim: To assess trends among medical students towards becoming general practitioners or specialists, exploring associated factors. Material and methods: Descriptive survey of 822 first to seventh year medical students at the University of Chile, School of Medicine. Desired activity to pursue (general practice or specialization) after graduation and general orientations within clinical practice were explored. Results: Fifty three percent of students desired to enter a specialization program. Only 20 percent would work as a general practitioner (27 percent were still indecisive). Furthermore, a trend in early years of medical training towards an integral medicine is gradually reversed within later years. Seventh year students give significantly more importance to specialization than to integral medicine (p <0.01). Ten percent of this opinion change is related to the emphasis given to specialized medicine in the teaching environment. Conclusions: Most students prefer to enter a specialization program immediately after finishing medical school. Moreover, there is a social trend, at least within the teacher-attending environment, promoting not only the desire to specialize, but a pro-specialist culture.